Wednesday, December 22, 2010

An Essay about Depression.

This is an essay on depression I wrote for a class. I got a fairly good grade on it. Works Cited are at the bottom of the page. I hope someone benefits from this. :)

Depression is a disease that affects thousands of people in all walks of life and in all cultures. It is even considered a leading cause of medical harm in developing countries. Despite its prevalence, depression is a disease that many people misunderstand. As a sufferer of depression, I hear a lot of people tell me that it is “all in my head” or that I should “just get over it.” Another misconception of depression is that it will simply go away once someone has been prescribed medication. Depression is a topic that many people do not wish to talk about. It is easy to understand why people who do not live with depression choose to avoid it as a topic of conversation. In general, when people hear that a friend has depression, they avoid that friend. It could be because they feel that their depressed friend will make them depressed or that they don’t know what to say to help. Many times, the avoidance response isn’t even a conscious decision. Because of the social pressure to not burden friends and family with negativity, many sufferers of depression do not wish to learn anything about their illness. Even though the disease may negatively impact their lives, they are hesitant to find out more information because they feel that learning about the disease acknowledges the fact that they are indeed ill. Doctors depend on input from patients in order to recommend treatments and evaluate the progress of treatments already in place. If a patient isn’t honest with the doctor, the doctor can only make guesses as to how to treat their patient. On top of this, doctors are pressured by pharmaceutical companies to sell “quick fixes” to as many patients as possible. This pressure tends to create a less than desirable relationship between doctors and patients, making patients even more hesitant to speak up.
A large majority of people believe that there are no physical symptoms associated with depression. Even people who have been diagnosed with depression do not believe that there are physical symptoms. A survey in Atlanta concluded that “72% of people with major depression did not believe, prior to their diagnosis, that painful physical symptoms such as unexplained headache, backache, gastrointestinal disturbance and vague aches and pains, were common symptoms of depression.” (World) yet over 75% of the respondents to the same survey reported that they were bothered enough by these symptoms to go see a doctor. Patients have a tendency to not go to a doctor unless something causes a significant disruption to their daily life. When a physical symptom comes up, especially one that is debilitating enough to affect performance at work or in school, many people wish for the condition to simply go away. They treat the problem as a disease in and of itself, rather than figuring out if it is a symptom of a more complicated illness. They go to the doctor with their physical complaints, and too often, depression isn’t even discussed. Doctors, when presented with unexplained physical symptoms rarely think of depression. As a result, a patient may be subject to a wide variety of tests that yield no useful results. Patients could avoid tensions with their doctor and doctors could save patients the aggravation of fumbling around for an answer if depression were discussed as a possible diagnosis.
When people do see a doctor for depression, they are often prescribed medication. Psychiatric medication has increased in popularity significantly in recent years. With the introduction of drugs such as Prozac, more and more people have been turning to psychiatric medications in order to cope with depression. In 2002 it was estimated “that around 46 million prescriptions were written for psychiatric medications” (Davis-Berman and Pestello) even though the documented side effects of these medications are quite unpleasant. Side effects can be uncomfortable and even life threatening, and yet people are hesitant to ask their doctors about them. Many sufferers of depression think that once they are on medication, the process of treating the disease is over. Advertisements for anti-depressant medication tend to mislead consumers into thinking that taking one pill will cure them. Advertisements also have a tendency to gloss over the potential side effects of the medications they are trying to sell. Even though some depression sufferers do see immediate improvement with the first medication they try while suffering no side effects, this is the exception rather than the rule. There is no magic pill that works for everyone. Each medication has different effects on the brain and no two brains are exactly alike. Unfortunately, the hesitation by patients to discuss the side effects of the medications they are prescribed often lead to a worsening of depression symptoms. The mental and physical side effects of medications, especially those that involve sexual function, often make the patient suffer symptoms of depression that are worse than the original complaint.
Patients are also hesitant to speak with their doctors after a diagnosis because they feel that their doctor will not take their complaints seriously. Many patients feel that they are rushed through the diagnosis and feel that they are pushed into taking medication. Some doctors prescribe several medications at once; sometimes it seems with complete disregard as to how the medications will react with each other. Several patients with depression report having bad experiences with doctors. Patients who are dissatisfied with doctors soon seek out the advice of others, often through internet chat forums. In a study of postings found in chat forums designed for depression sufferers it was found that, “Posters sometimes challenged diagnoses and treatments that they or others had been given by their physicians. In this situation, they sometimes suggested alternative diagnoses and medications. Posters who had been ‘‘involved’’ in the mental health field for an extended period of time seemed to see themselves as ‘‘quasi-experts’’. They seemed to feel that in some ways their experiences made them more knowledgeable than doctors.” (Davis-Berman and Pestello). These same posters also felt that they were qualified to give advice about the type of medication taken and the correct dosage. If doctors are unsure about the effects of anti-depressant medication, it seems unlikely that the average person has enough knowledge of the subject to be qualified to give out medical advice. Most doctors agree that psychiatric medications can be dangerous if taken improperly or stopped suddenly. Doctors often caution patients against diagnosing each other because when it comes to medication, no two people are identical. What works for one patient has the potential to kill someone else.
Generally, when someone seeks the advice of a physician, they want to have their health concerns taken seriously. There is a prevailing attitude amongst sufferers of depression that doctors do not take what patients say to heart. Sometimes, sufferers of depression feel that doctors believe that they are “crazy” and will do anything to get the patient out of their office. This encourages people to adjust their medications themselves or quit them entirely. When symptoms get worse, the patient is hesitant to return to the doctor because of previous negative experiences.
Even though there are millions of people under some sort of treatment for depression, there are countless others who are suffering in silence. In 2005 the World Health Organization reported that three-hundred-forty million people worldwide suffer from depression, yet it is estimated that three-quarters of people with a depressive disorder never receive any treatment. This is partially because of the belief that depression is something that only affects the mind. Surveys of physicians and psychiatrists in several countries suggest that there are many doctors that do not believe some unexplained physical symptoms can be a sign of depression. Employers do not believe depression is a legitimate reason for poor job performance. Several people with depression, including myself, have reported negative actions taken against them after they inform their employer that they may be suffering from depression. Because it is difficult to prove the existence of depression in a tangible way, there are people who use the label of depression as an excuse for poor job performance and attendance. The prevailing attitude then becomes that anyone who complains of depression must be faking it. People who genuinely would be diagnosed with depression become concerned with the stigma associated with the label and try to tough things out on their own. Also, most health plans offered by employers do not cover diagnosis and treatment of mental health problems, even though there are some physical issues associated with the disease. Many anti-depressant medications are expensive and often, to find a treatment that works, it takes months of experimentation with quite a few different drugs. Toughing it out seems like a better option, especially since there is no way to guarantee that treatment will be effective. Toughing it out also keeps the disease a secret from co-workers or supervisors.
In order to combat depression worldwide, I believe several things need to be taken into consideration. First, the public in general needs to be educated about depression. It seems that the only things people know about depression is what they see on ads paid for by the pharmaceutical industry. It needs to be understood that depression is a legitimate illness both by doctors and the public so that people will be more willing to seek treatment. More and more doctors are admitting that the current methods of treating depression are not effective and that more patients would be willing to accept treatments if they worked better. Doctors are also starting to discuss new treatments and the need for further education about depression. These are positive steps in the fight against depression but there is more to be done. Employers need to become more aware of depression and its symptoms and offer a way for people to get treatment if they need it. People who have depression need to be more up front with their doctors so that they can have the best treatment possible. Depression sufferers also need to be honest with themselves as to what treatments are working and what treatments are not.
Depression can be a debilitating illness and the stigma of diagnosis can make the problem even worse. Rather than relying on information based on misconceptions of the disease, doctors, employers and patients need to work together and educate each other. Through effort, mutual understanding, and honesty about symptoms and side effects, depression is a disease that can be beaten.
Works Cited

Davis-Berman, Jenifer, and Frances G. Pestello. "Taking Anti-depressant Medication: A Qualitative Examination of Internet Postings." Journal of Mental Health 17.4 (2008): 349-60. Web. 26 Nov. 2010.

"People with Depression Unaware of Painful Physical Symptoms of Depression." World Disease Weekly (2005): 1112. 28 June 2005. Web. 26 Nov. 2010.

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